Taking a drag from an e-cigarette may be just as safe and effective as slapping on a nicotine patch for smokers struggling to quit, according to the first physician-run trial to compare the products. About one in 20 people who used either patches or e-cigarettes quit completely six months after the test started, according to research published yesterday in The Lancet . Meanwhile, users of electronic cigarettes - battery-powered devices that deliver vaporised nicotine - were more likely to have halved their use of the real thing, even if they did not manage to quit entirely. The 657-person trial was not big enough to draw definite conclusions about whether e-cigarettes were better than nicotine patches, researchers said. Still, the results should be a signal to the regulators in the US and Europe now weighing restrictions on e-cigarettes, said Peter Hajek, a professor of clinical psychology at the Wolfson Institute of Preventive Medicine. "Health professionals will now hopefully feel easier about recommending e-cigarettes to smokers, or at least condoning their use," Hajek wrote in a commentary published alongside the results. If European and US regulators treat e-cigarettes as medical devices, yet leave cigarettes on general sale, tobacco makers "will retain their market monopoly, and we will never learn whether e-cigarettes would replace traditional cigarettes if allowed to continue evolving and competing with smoked tobacco on even terms," he wrote. The results are also being presented at the European Respiratory Society's annual meeting, which is under way in Barcelona, Spain. E-cigarettes have taken Europe and the US by storm. In France, there are more than 1 million regular users, according to a government-commissioned report published in May. Sales worldwide will probably approach US$2 billion by the end of this year and top US$10 billion by 2017, according to a forecast by Wells Fargo & Co. But the success has brought scrutiny. The French government said it planned to ban e-cigarettes from public places. Britain has moved to treat them as medicines. The US Food and Drug Administration may announce potential restrictions as early as next month. French magazine 60 Million Consumers reported in its September edition that it found formaldehyde and other chemicals, along with traces of heavy metals, when it tested a range of the devices. Certain brands contained dangerous substances in greater quantities than cigarettes, and the amount of nicotine in an e-cigarette is sometimes far more than what is listed on the label, according to the magazine. For the team of New Zealand-based researchers that conducted the latest study, the point was not to figure out whether e-cigarettes might lead new users to smoke, but rather how well the devices could help entrenched smokers to quit. The trial was funded by the Health Research Council of New Zealand. The team recruited smokers through newspaper advertisements. Participants had smoked an average of almost 20 cigarettes a day for the past 25 years and, to join the study had to want to stop. The team divided its recruits into three groups: assigning them to wear nicotine patches, or to get an e-cigarette with nicotine, or to receive an e-cigarette with a nicotine-free placebo vapour. Nicotine e-cigarette users who quit took more than twice as long as patch users to relapse - an average of 35 days.